Rotavirus

What is rotavirus?

Rotavirus has long been the most common cause of severe infection in the intestines, usually causing diarrhea. Although most cases occur between 6 months and 2 years of age, a rotavirus infection may affect people of any age. The vaccine has greatly reduced the number of rotavirus infections.

How does it occur?

People are infected with rotavirus by exposure to others with the infection. The virus can survive on surfaces, in water, and on skin. Children are often infected by getting the virus on their skin. In the United States, most infections occur in the winter.

What are the symptoms?

Symptoms may include:

• vomiting, usually lasting for about 2 to 3 days
• watery diarrhea that can last up to 8 days
• fever, usually less than 102°F (39°C) and usually lasting less than 3 days.

How is it diagnosed?

Your child's healthcare provider will ask about the symptoms. A test of your child's stool can be done to check if it is caused by rotavirus, but this is usually not necessary. With severe diarrhea, your child's provider may want to do a blood test to check if your child is very dehydrated.

How is it treated?

There are no specific medicines which help diarrhea caused by rotavirus. The most serious problem caused by severe diarrhea is dehydration, so replacing fluids is important. If possible, have your child drink extra fluids. If vomiting is severe your healthcare provider may want to give your child fluids given through a vein (IV).

Fluids should be given as early as possible in the illness (within 24 hours), to help the intestines heal. Infants may be given breast milk, formula, or products containing electrolytes (salts) which are specifically made for babies. Your healthcare provider can recommend a product. Infants should never be given water alone, since the salts lost in diarrhea also need to be replaced.

Older children can be given water or watered-down sports drinks. Fruit juices and carbonated soft drinks should be avoided, because they can make diarrhea worse.

Many parents ask about the use of "probiotics" (such as Lactobacillus) to help recovery from diarrhea. The ability of probiotics in helping control symptoms is still controversial and recent studies have shown conflicting results.

How long will it last?

Illness caused by rotavirus usually begins 12 hours to 4 days after being exposed to the virus. If vomiting occurs, it is usually over within 2 to 3 days. Fever and diarrhea generally last 4 to 8 days. Depending on the degree of damage to the intestine, the diarrhea may last up to 2 weeks, even though your child feels well.

How can I help prevent rotavirus?

It is very difficult for a child to avoid being exposed to rotavirus. Almost all children become infected at some time within the first 3 years of life. The rotavirus vaccine is recommended to prevent severe disease (which can lead to dehydration or death). The vaccine is very effective. The CDC says it will prevent about 74% of all rotavirus cases. It has prevented 98% of severe cases. There are two brands of rotavirus vaccine. A baby should get either 2 or 3 doses, depending on which brand is used.

The first dose may be given as early as 6 weeks of age, and should be given by age 14 weeks 6 days. The last dose should be given by 8 months of age.

This vaccine may be given at the same time as other routine childhood shots, such as DTaP, hepatitis B, and pneumonia shots.

When should I call my child's healthcare provider?

Call immediately if:

• Your child has had no wet diapers for more than 8 hours.
• Your child has very rapid breathing (more than 60 breaths in a minute) or trouble breathing.
• Your child is extremely tired or hard to wake up.
• You cannot console your child.
• Your child has chills.
• Your child is in severe pain.
• Your child has blood in the stool.
• Your child has a seizure.
• Your child has jaundice (a yellow color of the skin and the whites of the eyes).

Call during office hours if:

• Your child has a fever lasting more than 5 days.